gms | German Medical Science

51. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V. (gmds)

10. - 14.09.2006, Leipzig

Acute Depression in Hispanic Youth in California- Findings from the California Health Survey 2003

Meeting Abstract

Search Medline for

  • Maren Bredehorst - Universität Bielefeld, Studiengang: Master of Public Health, Bielefeld
  • Nadia Khelaifat - Universität Bielefeld, Studiengang: Master of Public Health, Bielefeld
  • Claudia Maier - Universität Bielefeld, Studiengang: Master of Public Health, Bielefeld

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e.V. (gmds). 51. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie. Leipzig, 10.-14.09.2006. Düsseldorf, Köln: German Medical Science; 2006. Doc06gmds205

DOI: 10.3205/06gmds383, URN: urn:nbn:de:0183-06gmds3831

Published: September 1, 2006

© 2006 Bredehorst et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Introduction and Research Question

Depression is a very frequent mood problem and is expected to be the second biggest health care problem after heart disease in 2020 [1]. Prevalence and age of onset is rising in young people [2], [3]. A large study conducted in the United States showed that people of Hispanic origins had a higher prevalence of depression than Whites [4]. The reasons remain unclear; they might be caused by race itself or by contextual factors. However, other studies showed contrasting results: immigrants from Mexico had lower rates of psychiatric disorders than non-immigrants [5].The present study aimed at investigating the association between race and the prevalence of acute depression in Whites and Hispanic youth. Possible determinants besides ethnicity were also examined.

Design and Methods

A secondary analysis was performed using data from the 2003 CHIS adolescent survey [6]. CHIS is a population-based, random-digital (RDD) telephone survey which is representative for California’s households. The analysis was based on 4,010 telephone-interviews with teenagers, comprising White youth (n=2071), Latino youth (n=1125), and “Others” (n= 814) measuring acute depression. A reduced version of the CES-D Scale with a cut-off point set at 11 scores was used [7]. The following variables were tested for inclusion in the model: age, gender, socio-economic status, self-perceived body weight, volunteering, physical activity, household crowding, social support at home and social support at school provided by adults.

The data analysis was carried out using SPSS 12.0. At the univariate and bivariate level, frequencies were calculated for the description of the sample and Chi-Square tests were carried out, testing for significant differences at the 5%-Level (p-value). At the multivariate level, logistic regression models were used. All significant variables at the p<0.25 level in the bivariate analysis were included in the preliminary main effects model [8]. In the final main effects model, adjusted Odd’s Ratios (ORs) and confidence intervals (CIs) were calculated. The variables of the main effects model were tested for significant interactions and stratified.

Results The prevalence of acute depression in Latino youth was 9.9%, and 4.9% in Whites (p<0.001). White youth (17%) in contrast to Latino youth (67%) came less often from lower income households. Social support provided by adults at school was higher for White students. The majority of White (60%) and Hispanic youth (52%) perceived themselves as having the right weight.

The final multivariate model for determinants of depression included six main effects and two interactions. Household crowding, volunteer work and exercising were excluded since they did not show significant associations with depression (p>0,05).

The results of the multivariate logistic regression (see Tabelle 1 [Tab. 1]) showed that lack of social support provided by adults carried the highest risk for depression. An increased risk was associated with Hispanic background, lower household income, being female and self-perceived overweight.

Significant interactions were identified between race and social support at school as well as race and poverty level. The combination of Hispanic background and little support at school, or small household income respectively, appeared to lower the risk for depression. The main effects identified were then stratified by “Race”. The risk associated with lack of support by adults at school differed between the two groups [White adolescents: OR 6.74 (95% CI: 3.64 – 12.46); Latino: OR 1.85 (CI: 1.01 – 3.41)]. A similar effect appeared for lower household income. The OR for the poorer White youth was 2.46 (1.58 – 2.86). In contrast, low income had no significant effect in the Latino group.

Discussion The prevalence of acute depression is twice as high in Latino as in White youth which confirms other studies [9, 10]. Sociodemographic and psychosocial disparities could partly explain the increased risk for Latino youth. Yet the risk of suffering from acute depression was still higher for Latinos than for White youth after adjusting for all covariates in the multivariate logistic regression. The stratified results revealed great differences between Latinos and Whites for the two covariates “social support at school” and “poverty level”: their adverse effects on mental health seem to be much smaller for Latino adolescents.

Some of the underlying concepts such as social support require extra consideration, i.e. the validity of the respective scales in the CHIS questionnaire. Also the CHIS questionnaire did not include any items on peer relationships, although they are found to be a major predictor of depression [9], [10].

These findings lead to the question how “Race” relates to the prevalence of depression. However, the reasons for the increased risk associated with Hispanic background could not be examined in this study. Further research is required regarding culture as some recent studies claim that it might be a protective factor without, however, observing or measuring it [11]. Thus a multidimensional concept of culture is needed.


References

1.
Üstün TB, Chatterji S. Global Burden of Depressive Disorders and Future Projections. In: Dawson A and Tylee A (Eds.). Depression: Social and Economic Timebomb. London: BMJ Books; 2001.
2.
Cross-National Collaborative Group. Cross-national comparisons. JAMA. 1992; 268: 3098-3105.
3.
Birmaher B, Ryan ND, Williamson DE, Brent DA, Kaufman J, Dahl RE, Perel J, Nelson, B. Childhood and adolescent depression: A review of the past 10 years. Part I. Journal of the American Academy of Child and Adolescent Psychiatry. 1996b; 35: 1427-1439.
4.
Blazer DG, Kessler RC, McGonagle KA and Swartz MS. The prevalence and distribution of major depression in a national community sample: The National Comorbidity Study. American Journal of Psychiatry. 1994; 151: 979-986.
5.
Grant BF, Stinson FS, Hasin DS, Dawson DA, Chou SP, Anderson K. Immigration and lifetime prevalence of DSM-IV psychiatric disorders among Mexican Americans and non-Hispanic whites in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Arch Gen Psychiatry. 2004; 61: 1226-33.
6.
California Health Interview Survey (CHIS). Dataset public use file; 2003. http://www.chis.ucla.edu/ (downloaded November 2005).
7.
Radloff LS. The Use of the Center for Epidemiologic Studies Depression Scale in Adolescents and Young Adults. Journal of Youth and Adolescence. 1991; 20: 149-166.
8.
Hosmer DW, Lemeshow S. Applied Logistic Regression. Second Edition., New York, Chichester: John Wiley & Sons; 2000.
9.
La Greca AM, Harrison HM. Adolescent peer relations, friendships, and romantic relationships: do they predict social anxiety and depression? Journal of Clinical Child and Adolescence Psychology. 2005, 34(1): 49-61.
10.
Prinstein MJ, Borelli JL, Cheah CS, Simon VA, Aikins JW. Adolescent girls' interpersonal vulnerability to depressive symptoms: a longitudinal examination of reassurance-seeking and peer relationships. Journal of Abnormal Psychology. 2005; 114 (4): 676-688.
11.
Hunt L. Health research: what's culture got to do with it? Lancet. 2005; 366: 617-618.
12.
Roberts RE, Chen YR, Roberts CR. Ethnocultural differences in prevalence of adolescent suicidal behaviors. Suicide Life Threat Behaviour. 1997; 27(2): 208-17.
13.
Fornos LB, Mika VS, Bavles B, Serrano AC, Jimenez RL, Villarreal R. A qualitative study of Mexican American adolescents and depression. Journal of School Health. 2005; 75 (5): 162-170.